| NPI | 1104426584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013800) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 194786) |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-12-18 |